Organization
FAMILY HEALTH SERVICES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY BLACKWOOD (CREDENTIALING SPECIALIST)
(208) 737-6718
Entity
Organization
Contact information
Practice address
260 3RD AVE N, TWIN FALLS, ID 83301-6130
(208) 734-1281
(208) 734-1282
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 734-3312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/14/2022
Last updated
07/21/2023
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